DA Form 2173 - Statement Of Medical Examination And Duty Status
Sep 9, 2022 · A DA Form 2173 is a document used by the Department of the Army when a soldier is injured in the line of duty. These documents must be completed within 7 days of the incident and are valid for 60 or 90 days. Upon completion, the document must be submitted for review and approval by superiors.
STATEMENT OF MEDICAL EXAMINATION AND DUTY STATUS For use of this form, see AR 600-8-4, the proponent agency is DCS, G-1. INJURY IS CONSIDERED TO HAVE BEEN INCURRED IN LINE OF
PRINCIPAL PURPOSE: To provide information regarding a Soldier’s status when injury, illness, disease or death occurs. It tracks and ensure Soldiers are receiving proper benefits and proper institutions/agencies are notified regarding payment and benefits.
Army Publishing Directorate
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DA FORM 2173 Fillable - Army Pubs 2173 PDF | DA Forms 2024
Officially titled “Statement of Medical Examination and Duty Status,” this form is an essential document for tracking and documenting the medical examinations and duty capabilities of service members.
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Fillable Form DA 2173 (2021) | Edit, Sign & Download in PDF
- DA Form 2173 (2021) is a Statement of Medical Examination and Duty Status used primarily for Line of Duty (LOD) investigations in the US Army. It's a medical form filled out by healthcare providers and unit commanders to document the circumstances surrounding an injury or illness incurred by a soldier.
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DA Form 2173. Statement of Medical Examination and Duty Status
DA Form 2173, also known as Statement of Medical Examination and Duty Status, is a document used by the Department of Defense (DoD) to record the medical status and duty limitations of military personnel. The form consists of three parts: Part I - Administrative Data, Part II - Medical Examination and Part III - Duty Status.
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